Promoting a Healthy Skin Barrier Using Skin Care in People With Mature Skin Xerosis
January 2024 | Volume 23 | Issue 1 | 1253 | Copyright © January 2024
Published online December 11, 2023
Michael Gold MD FAADa, Anneke Andriessen PhDb, Cheryl Burgess MD FAADc, Valerie Callender MD FAADd, David Goldberg MD JD FAADe, Firas Hougeir MD FAADf, Leon Kircik MD FAADg, Todd Schlesinger MD FAADh
aGold Skin Care Center, Nashville, TN; Vanderbilt University School of Medicine and Nursing, Nashville, TN
bRadboud UMC Nijmegen, Andriessen Consultants, Malden, NL
cCenter for Dermatology and Dermatologic Surgery, Washington, DC
dHoward University College of Medicine, Washington, DC; Callender Dermatology & Cosmetic Center, Glenn Dale, MD
eSkin Laser & Surgery Specialists of NY and NJ, Hackensack, NJ; Icahn School of Medicine at Mt. Sinai, New York, NY
fSoutheast Dermatology Specialists, Douglasville, GA
gIcahn School of Medicine, Mount Sinai, New York, NY; Dermatology, Indiana University Medical Center, Indianapolis, IN; Physicians Skin Care, PLLC, Louisville, KY; DermResearch, PLLC, Louisville, KY
Abstract
Introduction: Most people are living into their sixties and beyond. Fundamental changes in chronologically aged skin have significant and widespread dermatological implications. This review discusses aging-associated alterations in epidermal function leading to xerosis and related pruritus and the benefits of maintaining or restoring a healthy skin barrier using skincare, specifically ceramide-containing skincare.
Methods: A panel of 7 dermatologists convened for a meeting to review aspects of xerosis in mature skin, skin barrier changes, and nuances in the treatment and maintenance of mature skin using gentle cleansers and moisturizers. From the selected literature, 13 statements were drafted. During the meeting, the draft statements underwent the panel's evaluation at a workshop, followed by a plenary discussion adopting 5 statements using evidence from the literature coupled with the panel's opinions and experiences.
Results: The exact etiology of xerosis is not entirely understood and likely depends on several genetic and environmental mechanisms. Aging-associated changes in epidermal function include a marked reduction in total lipids in the stratum corneum relative to young skin due to reduced epidermal lipid synthesis. In aging skin, xerosis is significantly associated with pruritus. Studies have shown that lipid-containing skin care, such as a gentle ceramide-containing cleanser and moisturizer, promotes a healthy barrier reducing xerosis and pruritus in individuals with mature skin.
Conclusions: The development of xerosis in mature skin involves several genetic and environmental mechanisms. Skincare, including gentle cleansers and moisturizers, has reduced xerosis and pruritus in mature skin individuals.
J Drugs Dermatol. 2024;23(1):1253-1259. doi:10.36849/JDD.7560
INTRODUCTION
With advances in medical biology and healthcare technology over recent decades, human lifespans are increasing worldwide, resulting in a proportionate increase in the aged population.
1,2 Today, most people can expect to live into their sixties and beyond.
1
Fundamental dermal and epidermal changes in chronologically aged skin have significant and widespread dermatological implications.3,4 As early as 50, the frequency of aging-associated skin conditions increases, in parallel with epidermal dysfunction such as compromised permeability homeostasis, reduced stratum corneum (SC) hydration, and elevated skin surface pH.5-8 Studies have shown that epidermal dysfunction predisposes to xerosis, pruritus, atopic dermatitis, and contact dermatitis.9,10 Skin conditions affect up to 70% of matured individuals, with xerosis and pruritus as the most common skin disorders.5 The etiology of xerosis in mature skin is not fully understood but likely involves genetic and environmental factors leading to changes in the keratinization process and lipid content in the SC.
